Emine HAZAL AKTAŞ, Aslı ÇETİNKAYA YAPRAK

Açık Glob Yaralanmalarında Orbital Bilgisayarlı Tomografinin Tanı Koymadaki Duyarlılığı ve Buna Etki Eden Faktörlerin Değerlendirilmesi

Amaç: Açık glob yaralanmalarının tanısı oftalmolojik muayene ile konulmaktadır. Bu çalışmanın amacı açık glob yaralanması olan hastalarımızda acil şartlarda istediğimiz preoperatif orbital bilgisayarlı tomografinin (BT) tanı koymadaki duyarlılığının saptanması ve buna etki eden faktörlerin değerlendirilmesidir. Gereç ve Yöntem: Akdeniz Üniversitesi Hastanesi Göz Hastalıkları kliniğinde Eylül 2014 - Şubat 2021 tarihleri arasında açık glob yaralanması onarımı yapılmış hastaların verileri retrospektif olarak incelendi. Verilerine ulaşılabilen 290 hastanın demografik verileri kaydedildi. Hastalar korneal, skleral ve korneaskleral yaralanma; pediatrik ve erişkin yaş gurubu olarak sınıflandı. Preoperatif orbital BT raporundaki açık glob yaralanması, YC ve orbital fraktür varlığı kaydedildi. Bulgular: Çalışmaya 60 (%20,7) kadın, 230 (%79,3) erkek dahil edildi. Hastaların 58’i (%20) pediatrik, 232’si (%80) erişkindi. 155 (%53,4) hastada korneal, 76 (%26,2) skleral ve 59 (%20,3) korneaskleral yaralanmaydı. Preoperatif çekilen orbital BT raporunda 163 (%56,2) hastada açık glob yaralanması olduğu belirtilmişti. Pediatrik ve erişkin gruplarda orbital BT tanı koyma etkinliği arasında herhangi bir istatistiksel fark izlemedik (p=0,636). Kesi yerine göre değerlendirdiğimiz zaman; skleral ve korneaskleral yaralanmalar korneal yaralanmalar ile karşılaştırıldığında orbital BT’nin tanı koyma etkinliğinin daha fazla olduğunu gördük (p

Determining the Sensitivity in the Diagnosis of Preoperative Orbital Computed Tomography in Patients With Open Globe Injury and Evaluating the Affecting Factors

Purpose Open globe injuries are diagnosed by ophthalmological examination. The purpose of this study is to determine the sensitivity in the diagnosis of preoperative orbital computed tomography (CT) in our patients with open globe injury and to evaluate the affecting factors. Materials and Methods The data of patients who underwent open globe injury repair between September 2014 and February 2021 in the Akdeniz University Hospital Ophthalmology Clinic were retrospectively analyzed. Demographic data of 290 patients’ were recorded. Patients suffer from corneal, scleral and corneoscleral injury; classified as pediatric and adult age groups. The presence of open globe injury, foreign body(FB) and orbital fracture in the preoperative orbital CT report were recorded. Results Sixty (20.7%) women and 230 (79.3%) men were included in the study. Of the patients, 58 (20%) were pediatric and 232 (80%) were adults. There were corneal, 76 (26.2%) scleral, and 59 (20.3%) corneoscleral injuries in 155 (53.4%) patients. In the preoperative orbital CT report, it was stated that 163 (56.2%) patients had open globe injuries. We did not observe any statistical difference between the diagnostic efficiency of orbital CT in pediatric and adult groups (p=0.636). When we evaluate according to the location of wound; scleral and corneoscleral injuries were compared with corneal injuries, we found that orbital CT was more effective in diagnosing (p

PDF

___

1. Crowell EL, Koduri VA, Supsupin EP, Klinglesmith RE, Chuang AZ, Kim G, Baker LA, Feldman RM, Blieden LS. Accuracy of Computed Tomography Imaging Criteria in the Diagnosis of Adult Open Globe Injuries by Neuroradiology and Ophthalmology. Acad Emerg Med. 2017;24:1072-1079.
2. Kalaycı M, Çetinkaya E. Somali Popülasyonundaki Açık Glob Yaralanmalarının Epidemiyolojisi. Acıbadem Univ. Sağlık Bilim. Derg. 2021;12:92-196.
3. Kuhn F, Morris R, Witherspoon CD. Birmingham Eye Trauma Terminology (BETT): terminology and classification of mechanical eye injuries. Ophthalmol Clin North Am 2002;15:139–143.
4. Kuhn F, Morris R, Witherspoon CD, Heimann K, Jeffers JB, Treister G. A standardized classification of ocular trauma. Ophthalmology 1996;103:240–243.
5. Russell SR, Olsen KR, Folk JC. Predictors of scleral rupture and the role of vitrectomy in severe blunt ocular trauma. Am J Ophthalmol 1988;105:253–257.
6. Werner MS, Dana MR, Viana MA, Shapiro M. Predictors of occult scleral rupture. Ophthalmology 1994;101:1941–1944.
7. Dunkin JM, Crum AV, Swanger RS, Bokhari SA. Globe trauma. Semin Ultrasound CT MR. 2011;32:51-56.
8. Kim SY, Lee JH, Lee YJ, Choi BS, Choi JW, In HS, Kim SM, Baek JH. Diagnostic value of the anterior chamber depth of a globe on CT for detecting open-globe injury. Eur Radiol. 2010;20:1079-1084.
9. Greven CM, Engelbrecht NE, Slusher MM, Nagy SS. Intraocular foreign bodies: management, prog¬nostic factors, and visual outcomes. Ophthalmology 2000;107:608–612.
10. Kubal WS. Imaging of orbital trauma. Radio¬Graphics 2008;28(6):1729–1739.
11. Sung EK, Nadgir RN, Fujita A, Siegel C, Ghafouri RH, Traband A, Sakai O. Injuries of the globe: what can the radiologist offer? Radiographics. 2014;34:764-776.
12. Chazen JL, Lantos J, Gupta A, et al. Orbital soft-tissue trauma. Neuroimaging Clin N Am. 2014;24:425e37.
13. Gad K, Singman EL, Nadgir RN, et al. CT in the evaluation of acute injuries of the anterior eye segment. AJR Am J Roentgenol. 2017;209:1353e9.
14. Hoffstetter P, Schreyer AG, Schreyer CI, et al. Multidetector CT (MD-CT) in the diagnosis of uncertain open globe injuries. Rofo. 2010;182:151–154.
15. Joseph DP, Pieramici DJ, Beauchamp NJ Jr. Computed tomography in the diagnosis and prognosis of open-globe injuries. Ophthalmology. 2000;107:1899–1906.
16. Weissman JL, Beatty RL, Hirsch WL, Curtin HD. Enlarged anterior chamber: CT finding of a ruptured globe. AJNR Am J Neuroradiol 1995;16:936–938.